Provider Demographics
NPI:1043603327
Name:ROBERT S. BARRY MD, INC
Entity Type:Organization
Organization Name:ROBERT S. BARRY MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-922-3573
Mailing Address - Street 1:1420 S MILLER ST STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6960
Mailing Address - Country:US
Mailing Address - Phone:805-922-3033
Mailing Address - Fax:
Practice Address - Street 1:1420 S MILLER ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6960
Practice Address - Country:US
Practice Address - Phone:805-922-3033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95002056261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care